Infections: bacterial, viral, fungal, parasitic: purpura fulminans in a febrile child: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Infections: bacterial, viral, fungal, parasitic: purpura fulminans in a febrile child

Sample item

A 6-year-old has had fever and vomiting for a few hours, and now has non-blanching purpuric spots spreading over the trunk and limbs, cold peripheries and a blood pressure of 80/50 mmHg. What is the most appropriate immediate action?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Give intravenous ceftriaxone at once

Fever with rapidly spreading non-blanching purpura and shock suggests meningococcaemia, a time-critical emergency. A third-generation cephalosporin should be given immediately after drawing blood cultures, with fluid resuscitation, and must not be delayed for lumbar puncture, which is unsafe in shock.

Option by option

  • A. Observe and repeat the blood count in 24 hours

    Waiting 24 hours risks death, since meningococcal sepsis progresses within hours.

  • B. Do a lumbar puncture before any treatment

    Lumbar puncture in a shocked child is unsafe and delays life-saving antibiotics.

  • C. Give intravenous ceftriaxone at once (correct)

    Correct. Parenteral ceftriaxone without delay is the priority, with fluids and supportive care.

  • D. Start oral penicillin V and review tomorrow

    Oral therapy is inadequate for septicaemia with shock.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Give intravenous ceftriaxone at once. Fever with rapidly spreading non-blanching purpura and shock suggests meningococcaemia, a time-critical emergency.

Why is "Observe and repeat the blood count in 24 hours" not the answer?

Waiting 24 hours risks death, since meningococcal sepsis progresses within hours.

Why is "Do a lumbar puncture before any treatment" not the answer?

Lumbar puncture in a shocked child is unsafe and delays life-saving antibiotics.

Why is "Start oral penicillin V and review tomorrow" not the answer?

Oral therapy is inadequate for septicaemia with shock.

What concept does this question test?

It tests Infections: bacterial, viral, fungal, parasitic: purpura fulminans in a febrile child in Dermatology. A third-generation cephalosporin should be given immediately after drawing blood cultures, with fluid resuscitation, and must not be delayed for lumbar puncture, which is unsafe in shock.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infections: bacterial, viral, fungal, parasitic: purpura fulminans in a febrile child?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.